High frequency of antibodies to Hantaan virus and hepatitis C virus in chronic haemodialysis patients. Coincidence or cross-reaction?

OBJECTIVES

To address the question of whether there is any coincidence or cross-reaction between hepatitis C virus (HCV) and Hantaan virus (both RNA arboviruses), as well as to assess the frequency of antibodies to the above viruses amongst chronic haemodialysis patients in our region.

DESIGN

Collection of serum samples from consecutive unselected chronic haemodialysis patients.

SETTING

A tertiary referral center (University Hospital).

SUBJECTS

One hundred and fourteen chronic haemodialysis patients were investigated for the presence of antibodies to HCV (anti-HCV) and Hantaan virus disease (anti-HVD). Eleven unselected non-haemodialysis patients with well-defined haemorrhagic fever with renal syndrome (HFRS) were also investigated for the anti-HCV antibodies comprising the disease control group.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

The utility of an anti-HVD positive test in chronic haemodialysis patients.

RESULTS

Seventeen patients (14.9% 95% confidence interval [CI] 8.4-21.4%) were anti-HCV positive, whereas 15 (13.2%, 95% CI 6.9-19.3%) were anti-HVD positive. An anti-HCV positive test was confirmed by recombinant immunoblot assay (RIBA II) in 88.2%. The presence of anti-HCV antibodies was not associated with transfusions but with the longer duration of haemodialysis (62.8 +/- 29.8 vs. 31.2 +/- 29.3 months, P < 0.001). Anti-HVD antibodies were not associated with transfusions or with the duration of haemodialysis. Three patients were positive for both anti-HCV and anti-HVD antibodies. None of the 11 patients with well-defined HFRS had anti-HCV antibodies.

CONCLUSIONS

Chronic haemodialysis patients are a high risk group for HCV infection in association with the duration of haemodialysis and, at least for our geographical area, these patients have to be examined for anti-HVD antibodies especially when a definite causative agent for chronic renal failure is not found. The HVD and HCV infection are not exceptional amongst haemodialysis patients in our region, whereas the possibility of a cross-reaction between these two RNA arboviruses is rather excluded as there was no evidence of HCV infection amongst the patients with well-defined HFRS.